Individual
MS. TAMMY M MARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
341 N. 4TH AVE W., MIDDLETON, ID 83644
(208) 703-1098
Mailing address
P.O. BOX 53, MIDDLETON, ID 83644
(208) 703-1098
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
MASG-91
ID
225700000X
Massage Therapist
—
ID
Other
Enumeration date
01/28/2010
Last updated
06/09/2014
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